<div class="panel panel-info">
	<div class="panel-heading">{{'PrestationType.FEES' | translate}}</div>
	<div class="panel-body">
		<div class="form-horizontal">
			<div class="form-group">
				<label class="col-sm-2 control-label" translate="Sinister.months"></label>
				<div class="col-sm-3">
					<input type="text" ng-model="sinister.months" number>
				</div>
				<label class="col-sm-2 col-sm-offset-1 control-label" translate="Sinister.cuoteImport"></label>
				<div class="col-sm-3">
					<input type="text" ng-model="sinister.cuoteImport" amount>
				</div>
			</div>
			<div class="form-group">
				<label class="col-sm-2 control-label" translate="SinisterInfo.estimatedAmount"></label>
				<div class="col-sm-3">
					<input type="text" ng-model="sinister.sinisterInfo.estimatedAmount" amount>
				</div>
			</div>
		</div>
	</div>
</div>
